娄灵芝+李靖+王少武+沈佼+王凯

摘 要 目的：評估社区站点家庭一体化康复对脑卒中的疗效。方法：抽取社区90例脑卒中患者，随机分为康复组（45例）和对照组（45例）。康复组的平均年龄（72.9±9.9）岁，对照组的平均年龄（73.0±7.8）岁。康复组的患者在经过康复评估后，接受站点家庭一体化康复治疗干预，由治疗师和中医师在站点进行指导和治疗，家属在家协助治疗，包括手法治疗、作业治疗、物理治疗、中医传统康复治疗和日常生活能力训练，并对家属进行培训和让家属协同训练。对对照组患者不采取康复治疗，在整个研究过程中两组药物治疗方案维持不变。3个月后采用简明精神状态量表（MMSE）、简易Fugl-Meyer运动量表、改良Barthel指数评定量表对两组患者认知功能、运动功能、日常生活活动能力进行评价。结果：干预后，康复组患者的认知功能、运动功能、日常生活能力均有明显提高（P<0.001）；对照组患者的认知功能、日常生活活动能力也有明显提高（P<0.005），运动功能没有明显改善（P>0.05）。但康复组的认知功能、日常生活活动能力得分均明显高于对照组（P<0.005）。结论：脑卒中社区站点家庭一体化康复治疗能够有效地改善脑卒中患者认知功能、运动功能和日常生活活动能力，是适合社区的康复模式，可进一步在社区探索和推广。

关键词 脑卒中；康复；社区站点；家庭

中图分类号：R743.3 文献标志码：A 文章编号：1006-1533（2018）02-0057-04

Analysis of the effect of the integrated rehabilitation of community health service stations with families on stroke patients

LOU Lingzhi1， LI Jing2， WANG Shaowu3， SHEN Jiao4， WANG Kai5

（1.Department of TCM of Shimenerlu Community Health Service Center， Jinan District， Shanghai 200041， China； 2.Office of Caojiadu Community Health Service Center， Jinan District， Shanghai 200042， China； 3.Outpatient Rehabilitation of Shanghai Fourth Rehabilitation Hospital，Shanghai 200042， China； 4.Ward of Nanjingxilu Community Health Service Center， Jinan District， Shanghai 200041， China； 5.Neurological Rehabilitation of Shanghai Fourth Rehabilitation Hospital， Shanghai 200042， China；）

ABSTRACT Objective： To evaluate the effect of the integrated rehabilitation of community health service stations with families on stroke patients. Methods： Ninety patients were enrolled in the community and randomly divided into a rehabilitation group（45 cases） and a control group（45 cases）. The average age of the rehabilitation group was （72.9±9.9） years， and the average age of the control group was （73±7.8） years. After rehabilitation assessment， the patients in the rehabilitation group received the treatment intervention by integrated rehabilitation of community health service stations with families， and the therapists and the herbalists of the community health stations provided guidance and treatment and the family members helped with the treatment at home， including manual therapy， occupational therapy， physical therapy， traditional Chinese medicine rehabilitation treatment and daily living ability training. The family members were trained and let them cooperate the training. The patients in the control group did not take rehabilitation treatment. Both groups maintained drug regimens unchanged throughout the course of the study. Three months later， a Mini-mental state examination scale （MMSE）， a simple Fugl-Meyer motor function scale and a modified Barthel index scale were used to evaluate the cognitive function， motor function and activity ability of daily living of the patients in the two groups. Results： After the intervention， the cognitive function， motor function and activity ability of daily living of the rehabilitation group were significantly improved（P<0.001）. The cognitive function and activity ability of daily living of the patients in the control group were also significantly improved too（P<0.005）， and motor function was not improved significantly（P>0.05）. But the scores of cognitive function and activity ability of daily living in the rehabilitation group were significantly higher than those in the control group（P<0.005）. Conclusion： The integrated rehabilitation of community health service stations with families can effectively improve the cognitive function， motor function and activity ability of daily living of the stroke patients， is a rehabilitation mode suitable for the community， and can be further explored and promoted in the community.endprint

KEY WORDS stroke； rehabilitation； community health station； family

脑卒中是威胁人类生命和健康的常见病和多发病，具有高发病率、高病死率、高致残率的特点[1-2]。近年来，脑卒中的病死率已呈逐年下降趋势[3]，但其引起的一系列功能障碍严重影响着患者的生存质量，给家庭和社会带来沉重的负担[4]。在住院治疗的急性或亚急性期脑卒中患者中，只有少数脑卒中患者在出院后恢復期能得到有效、规范化的护理和治疗[5]。面对社区实际增长的康复需求和卫生服务中心承担的康复重任[6]，本中心开展了社区站点家庭一体化脑卒中患者康复服务，本文旨在评估服务效果。……